Vasantha K. Perkari, MD

Products And Services

• Internal Medicine

  Internal Medicine is the medical specialty in which physicians provide comprehensive, patient-centered primary health care to patients and their families. Physicians who practice Internal medicine can provide routine wellness care, such as physical exams or preventative care, to patients, above the age of eighteen regardless of gender, health or social status. They are also trained to know about many areas of medicine so that they are equipped to treat a wide variety of conditions. Internal Medicine practices often staff a team of professionals that can help provide a continuity of care to patients, including nurse practitioners, physician assistants and others. The Purpose of Internal Medicine The goal of Internal medicine specialty is to provide continual, comprehensive care to an individual. Internal medicine advocates believe that seeing many different specialists can sometimes result in fragmented care. But physicians who practice Internal medicine are trained in providing coordination of care and will refer patients to specialists when necessary. Frequently, they can also provide information about other community resources or health services.. Some of the services that Internal Medicine Physicians offer may include: Diagnosis, treatment and prevention of chronic disease Immediate care for sudden and serious illness or injury Routine physical exams as well as sports clearance physical exams Vaccinations Preventative medicine Internal Medicine physicians may also be trained in subspecialties, such as: Geriatric medicine Hospice and palliative medicine Sub Acute Medicine Sports medicine Sleep medicine Mental health The Benefits of Internal Medicine Physicians who practice Internal medicine can treat patients above the age of 18, regardless gender, social status or health issue. Internal Medicine Physicians are specially trained to solve diagnostic problems, manage severe long-term illnesses and help patients control multiple complex chronic conditions. Having an Internist allows members of the family, from young adult to an elderly age, to set the same doctor. This enables the doctor to develop a trusting and genuine personal relationship with the family, which can result in better care. An Internal Medicine doctor who cares for a family over a period of years may also be able to provide better guidance about how to maintain a healthy lifestyle, especially if the doctor knows the family's medical history firsthand or has seen patterns of health problems. By adapting lifestyle changes and new health habits, patients may be able to avoid costly medications or procedures that can later affect them. Generally, specialists treat conditions that already afflict a patient. Internal Medicine doctors are equipped to treat chronic disease, ongoing health needs or other conditions and can help a patient develop a personalized, cost-effective treatment plan.

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• Arthritis

  Arthritis is a condition that causes pain, stiffness and swelling in the joints. Osteoarthritis is a common form of arthritis caused by the wearing down of the cartilage that protects the bones of a joint. Rheumatoid arthritis is an autoimmune condition caused by an inflammation in the lining of the joints. Both forms of arthritis cause pain, tenderness, and swelling, and may result in loss of movement in the affected joints. Over time, joints affected by arthritis may become severely damaged. Arthritis occurs more frequently in older individuals, however it sometimes develops in athletes from overuse of a joint or after an injury. It can however, affect people of any age, including children. In addition to rheumatoid arthritis and osteoarthritis, there are other types of arthritis, and depending on the cause, may affect people of different ages. Gout is a form of arthritis caused by a build-up of uric acid within the body, that causes painful, swollen, red and inflamed joints. Psoriatic arthritis affects people who have psoriasis, a skin condition characterized by red and scaly patches of skin. Psoriatic arthritis is considered an autoimmune disorder and causes joint inflammation, stiffness and pain. Diagnosis of Arthritis Arthritis is diagnosed through a physical examination, diagnostic tests and imaging exams to evaluate the affected areas of the body. Diagnostic tests may include: Blood tests Urinalysis Joint fluid testing X-rays MRI scans An arthroscopy may also be performed to assess damage within the joints. Treatment for Arthritis Treatment for arthritis varies based on the type and symptoms. Treatment may include medication to control pain, minimize inflammation and slow the progression of joint damage. Exercise and physical therapy may also be effective at keeping joints flexible. In severe cases, surgery may be recommended to repair tendons or replace damaged joints. In addition to medical treatment, some forms of arthritis may respond to lifestyle changes such as losing weight, eating a healthy diet and exercise. Heat and cold therapy may also relieve pain and swelling in joints and assistive devices such as canes or walkers may assist individuals with arthritis with mobility.

  Link: Arthritis

• Heart Attack

  A heart attack occurs when the coronary arteries, the blood vessels that deliver blood to the heart, are suddenly blocked and cannot supply the heart with blood and oxygen. This blockage causes damage and gradual death of the heart muscle and often requires immediate treatment in order to save the person's life. Also known as a myocardial infarction, heart attacks most often occur as a result of coronary artery disease, a condition in which plaque builds up inside the arteries. Heart attacks are the leading cause of death for men and women in the United States. Causes of a Heart Attack A heart attack is usually caused by atherosclerosis, a buildup of cholesterol, fat and other substances within the coronary arteries. As these substances, known collectively as plaque, build up, they cause the coronary arteries to narrow making proper blood flow more difficult. This condition is known as coronary artery disease, and is the most common type of heart disease. If the plaque breaks open, a blood clot forms around the plaque. The clot may completely block oxygen-rich blood from reaching the heart muscle, causing a portion of the heart muscle to die. A heart attack may also be caused by other conditions including: Coronary artery dissection, a tear in the heart artery Coronary embolism Another less common cause of a heart attack is a coronary artery spasm. These spasms are often caused by drug abuse, and when they occur, they suddenly cut off blood flow through the artery. Symptoms of a Heart Attack The initial symptoms of a heart attack may vary, but often include chest pain or discomfort. It may feel like fullness, pressure, squeezing or pain and it can come and go every few minutes. Other common heart attack symptoms include: Pain in the upper abdomen Shortness of breath Sweating Fainting Nausea and vomiting Dizziness Anxiety Jaw pain Arm, shoulder or back pain In addition to the above symptoms, women may experience other symptoms, including: Heartburn Abdominal pain Fatigue Light headedness Clammy skin Some people may not experience any symptoms at all. Some heart attacks may occur suddenly, but most people have warning signs and symptoms prior to the actual heart attack. The earliest warning sign is often recurrent chest pain that may occur days or weeks in advance. Risk Factors for a Heart Attack There are several factors that can increase the risk of a heart attack by contributing to the buildup of plaque within the coronary arteries. These factors may include: Advanced age Smoking High blood pressure High cholesterol Obesity Diabetes Physical inactivity Stress Alcohol Illegal drug use Individuals may be more at risk if they have a family history of heart attacks. There is also a link between certain autoimmune conditions, such as rheumatoid arthritis and lupus, and an increased risk of a heart attack. Diagnosis of a Heart Attack In many cases, a heart attack is diagnosed in an emergency setting and if the patient is conscious, he or she will be asked to describe the symptoms. The patient is hooked up to a heart monitor and an electrocardiogram is administered. The following diagnostic test may also be performed: Blood tests Chest X-ray Echocardiogram Coronary catheterization (angiogram) CT and MRI scans may also be performed to diagnose any heart problems and the extent of damage from a heart attack. Treatment of a Heart Attack A heart attack is an emergency that requires immediate treatment. Anyone experiencing symptoms of a heart attack should call 911 right away. Early treatment of a heart attack can help minimize damage to the heart muscle. Treatment for a heart attack usually includes cardiopulmonary resuscitation (CPR) to deliver oxygen to the body and brain, aspirin to prevent blood clots, thrombolytics to break up any existing clots, and nitroglycerin to treat chest pain. In some cases, surgery may be necessary to open blocked arteries, either through balloon angioplasty or a coronary artery bypass. Preventing a Heart Attack A heart attack can be prevented, even in individuals who have already experienced one. The risk of a heart attack may be lowered by the following: Not smoking Healthy diet Regular exercise Lowering stress levels Blood-thinning medications Controlling blood pressure and cholesterol levels Controlling diabetes Beta blockers and ACE inhibitors Individuals who suffered from a previous heart attack can lower their risk of subsequent heart attacks through lifestyle changes, cardiac rehabilitation, and medication that helps the heart recover from any previous damage.

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• Hearing Loss

  Hearing loss is the sudden or gradual decrease in hearing. Hearing loss can be mild or severe, reversible, temporary or permanent, and may affect one or both ears. The most common cause of hearing loss is age, affecting up to 25 percent of people between the ages of 65 and 75 and up to 50 percent of those over the age of 75. Age-related hearing loss, known as presbycusis, results from changes in the ear which cause gradual hearing loss. Some individuals are hearing-impaired or deaf as a result of a congenital defect or because of an illness, such as Ménière's disease. Causes of Hearing Loss Most cases of hearing loss are caused by damage to the inner ear. Temporary or permanent hearing loss in people of all ages may be caused by: Chronic exposure to loud noises, such as loud music or machinery Wax buildup in one or both ears Family history Fluid buildup due to ear infection Foreign object stuck in the ear canal Ototoxic medication Hearing loss may be caused by perforation of the eardrum from illness or injury or damage to the tiny bones, or ossicles, of the ear. Types of Hearing Loss There are three basic types of hearing loss, varying both in causes and treatment. Conductive In conductive hearing loss, the problem results from a structural or blockage problem with the outer or middle ear. This variety of hearing loss, which causes sounds to be less audible, is most often treated with surgery. Sensorineural In sensorineural hearing loss, the difficulty results from damage to the inner ear or to the auditory nerve, most commonly because the hair cells are not functioning properly. Sensorineural hearing loss, which causes sounds to be less intelligible, is often treated successfully with hearing aids. Mixed Hearing Loss Mixed hearing loss occurs when the patient suffers from hearing loss as a result of both neural and conductive malfunctions affecting both the both the outer or middle and the inner ear. Mixed hearing loss is most often treated with bone anchored hearing aids. Hearing loss may affect a person's relationships, employment, education, and general quality of life. People with significant hearing loss may also suffer from feelings of isolation, depression and anxiety. Symptoms of Hearing Loss While hearing loss may affect social interaction and other aspects of daily life, people are often unaware that they have a loss of hearing until others point it out to them. Common signs and symptoms of hearing loss may include: Muffled or unusually loud speech Inability to understand or decipher conversation Sensation that one or both ears are plugged Tinnitus, or ringing in the ears People who are suffering from hearing loss may constantly have a need for increased volume on radio or television. Diagnosis of Hearing Loss Hearing loss is diagnosed through a physical examination and various hearing tests may be performed. Tuning fork tests can help to diagnose whether the vibrating parts of the middle ear, including the eardrum, are working properly and whether there is damage to the sensors or nerves of the inner ear. Audiometer tests are used to determine the limits of the individual's hearing. Treatment of Hearing Loss Treatment of hearing loss depends in the cause of the problem. For temporary loss of hearing due to wax buildup, a thorough cleaning of the ear canal, also known as an irrigation or lavage, may be helpful. Hearing loss caused by an ear infection may be treated with antibiotics and decongestants to rid mucus from the ears. For more permanent types of hearing loss resulting from aging, or damage to the inner ear, hearing aids may be helpful, although adjusting to them may take a few weeks. When the eardrum has been torn or perforated, a surgical procedure known as tympanoplasty, may be necessary to repair the eardrum. Individuals with more profound hearing loss as a result of a congenital defect, injury or disease, may benefit from the surgical implantation of a cochlear implant, a small electronic device that helps to provide a sense of sound. Individuals coping with severe hearing loss may also learn to pay careful attention to gestures and facial expressions, to read lips, or to use sign language in order to improve their communication skills.

  Link: Hearing Loss

• Autism

  Autism, or autism spectrum disorder (ASD), encompasses a range of pervasive developmental disorders. These disorders vary in degree from mild forms like Asperger's syndrome to severe impairment. Autism is characterized by difficulties with communication and social interaction and by repetitive behavior patterns. The disorder has become very common, occurring in more than 1 percent of children. Autism is four times more likely to occur in males. Besides Asperger's syndrome, there are several other types of ASD, including pervasive developmental disorder not otherwise specified, childhood disintegrative disorder, and Rett's syndrome. Causes of Autism The causes of autism remain unknown, but it is believed to have both genetic and environmental roots. Families in which there is one autistic child have a greater chance of having another with the disorder. Children in families with certain psychiatric illnesses, like bipolar disorder, also appear to be at greater risk for autism. There are observable abnormalities in the brains of individuals with autism and several mutated genes that appear to regulate fetal brain development and neurotransmission have been identified. There is a great deal of research being done on the causes of autism. Suspicions that autism was the result of defective parenting or of particular immunizations have been scientifically disproven. Signs of Autism There are many signs that a child may be autistic. The disorder is usually diagnosed in children between the ages of 2 and 6 and early intervention has been found to significantly increase their coping skills. Even in infancy, there are often some symptoms of the disorder. Children may not make normal eye contact, may not respond to their names, or may not smile as frequently as their peers. Language skills are delayed, or may appear to develop normally and then diminish. Children with autism may exhibit other signs of the disorder, including: Obsession with a particular item Focusing on part of a toy or other object, rather than on the whole Inability to interpret facial expressions or body language Lack of empathy Preferring to play alone Speaking with peculiar intonation or rhythm Inability to converse Engaging in repetitive movements, like spinning or hand-flapping Inability to accept change Ritualized behavior patterns Oversensitivity to touch or sound Insensitivity to pain Symptoms of autism usually improve with age and effective treatment methods. Treatment for autism typically includes medication, therapy and behavioral interventions. Diagnosis of Autism While parents, friends and teachers may observe behavior patterns consistent with autism, the disorder should always be diagnosed by a medical professional. Autism, like other psychiatric disorders, is diagnosed according to criteria set down by American Psychiatric Association that appear in the Diagnostic and Statistical Manual of Mental Disorders, or DSM. Recently, the criteria for autism have been changed somewhat by the American Psychiatric Association so that some children who were previously diagnosed with autism are now diagnosed with social communication disorder, or SCD. This new designation lowers the number of children designated as autistic by approximately 10 percent. The decision to change the diagnostic criteria is a controversial one since some fear it will keep certain children from getting the services they require. Treatment of Autism Autism is most often treated with a combination of applied behavioral analysis and medication. In some cases, alternative therapies are also used in an attempt to improve emotional stability and to normalize behavior. Applied Behavioral Analysis Applied behavioral analysis is a highly structured protocol designed to help improve language and social skills by dividing tasks into incremental steps and rewarding each small success. Typically administered by mental health care professionals, such techniques can also be taught to family members and teachers so the therapy is reinforced in all environments. Family therapy is also helpful in assisting family members as they cope with the emotional stresses of dealing with the autistic child. Medications While autism is not a curable condition, physicians may prescribe medications to treat symptoms related the disorder, such as obsessive-compulsive behavior, social anxiety, depression, and hyperactivity. In some cases, antipsychotic medications may also be used to treat severe behavioral problems. Since 20 to 30 percent of patients with autism will develop epilepsy, anti-seizural medication may also be administered.

  Link: Autism

• Long-Term Care

  Long-term care involves a comprehensive range of services and support for patients who need assistance caring for themselves. These services can be beneficial for a patient with a chronic illness, or serious injury or disability, who is unable to care for him- or herself for an extended period of time. Although long-term care is most frequently used by older adults, patients of any age may need long-term care, especially following serious injury or debilitating illness. Long-term care may be provided in a facility, such as a nursing home or rehabilitation center, or a patient's home. Reasons for Long-Term Care Patients often need long-term care when they have a progressive health condition or disability that leaves them weakened or incapacitated. The need for long-term care may also arise following a major injury or an acute health crisis. Several factors may increase the risk of needing long-term care. They include a person's age, with the risk of needing long-term care increasing with age; gender, with women at higher risk because they live an average of 5 to 10 years longer than men; lifestyle, with poor diet and lack of exercise typically increasing the risk; health status, with increased risk for those who have chronic health conditions (diabetes, high blood pressure); and family history, with those with close relatives who have chronic conditions at greater risk. Types of Long-Term Care The duration of long-term care varies, depending on the patient's specific needs. Some patients require long-term care for only a few weeks or months as they recover from sudden illness or injury. However, in many cases, long-term care is ongoing, as it is for a patient who has been significantly disabled from an acute event or progressive disease. Home Care Home care is a form of long-term care provided within a patient's home by family members, friends, volunteers and/or paid healthcare providers. It includes assistance with both healthcare and the patient's personal needs, such as food shopping/preparation, dressing, taking medications and housekeeping. Community Services Programs designed to supplement existing long-term care, community services are often useful for a patient with an illness such as Alzheimer's disease or Parkinson's disease. A patient using community services usually attends an adult daycare program or participates in various activities, and may take part in a meal program. Assisted-Living Facilities An assisted-living facility provides a patient with 24-hour supervision, assistance and healthcare services in a setting similar to his or her own home. Transportation and laundry services, and help with eating, dressing and bathing, are also provided. Skilled Nursing Facilities Skilled nursing facilities offer more extensive care for a patient who can no longer receive care at home or in an assisted-living facility. Each type of long-term care has its own benefits. Home care enables a patient to receive care in the comfort of her or his own home, without having to pay for a nursing home. In some cases, home healthcare is covered by Medicare. Community services allow patients to remain active in a community, and can give the primary caregiver a respite. Assisted-living facilities provide long-term care assistance, while still enabling the patient to maintain a sense of independence. A patient in an assisted-living residence can also take part in various social and recreational activities. Skilled nursing facilities offer numerous benefits, including the continuous presence of medical personnel; rehabilitation services; meals; activities; and assistance with all daily-care needs.

  Link: Long-Term Care

• Low Blood Pressure

  Low blood pressure, also known as hypotension, is a goal that many people try to achieve in order to avoid the symptoms and complications of high blood pressure. Yet when blood pressure is too low, it can be a serious medical condition, potentially causing permanent damage to the heart and the brain. Blood pressure is measured by the amount of pressure generated when the heart is pumping blood. Blood pressure is measured in two sets of numbers. The first number is the systolic reading, which is the pressure when the heart is beating. The second number is the diastolic number, the pressure when the heart is resting. Maintaining a blood pressure equal to or lower than 120/80 is considered healthy, but if measurements go below 90 systolic or 60 diastolic, serious complications may arise. Some people have low blood pressure all the time, often with no symptoms, while others may develop it as a result of pregnancy, medication or dehydration, or after standing up or eating. Symptoms of Low Blood Pressure While some people may not experience any symptoms from low blood pressure, others may experience: Dizziness Fainting Nausea Blurred vision Fatigue Depression Treatment of Low Blood Pressure Many cases of low blood pressure can be treated with simple home remedies such as increasing salt intake, drinking more water and using compression stockings. It is important to address the underlying cause when treating low blood pressure. Certain medications can also help treat the condition. Although low blood pressure may not cause problems for most people, maintaining a healthy blood pressure is important in order to maintain health and prevent heart damage.

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• Medical Laboratory Testing

  Laboratories are a vital part of the world of medicine since modern medical laboratories do important diagnostic work for specialists in every medical field. While many medical laboratories do a variety of tests, some laboratories specialize in particular types of testing. Cytopathology Cytopathology laboratory testing involves the examination of cell smears from various parts of the body to check for malignancy, inflammation or other problems. Examples of cytopathological tests are Pap smears for cervical examination or microscopic examination of skin cells to detect skin cancer. Cytopathology may also be used to test for allergies through, for example, the examination of nasal smears. Genetics Genetic testing evaluates DNA and may include the examination of blood and other cells to evaluate the number, shape and size of chromosomes. This testing, called karyotyping, is useful in detecting congenital abnormalities in a child or a fetus, in determining whether a genetic defect may be passed from parent to child, in examining the cause of a birth defect or in assessing whether chromosomal damage has been the cause of a miscarriage or stillbirth. It is also used for forensic testing to establish identity. Hematology Hematology concerns the study of blood. The most common hematology or blood test is the complete blood count or CBC. A CBC measures the amount of hemoglobin in the blood as well as the number of red blood cells, white blood cells and the hematocrit, or percentage of the blood made up of red blood cells. Medical laboratories do many other blood tests, including platelet counts. Blood testing is an important tool in evaluating organ function, diagnosing illnesses, checking the efficiency of clotting, checking medication levels, discerning blood types and Rh factors, and checking for toxins in the blood. Immunology/Serology These tests involve using antigen/antibody interactions as tools to diagnose the compatibility of organs being considered for transplant. Microbiology Microbiologists work mainly with cultures, looking for suspected pathogens in clinical specimens. The specimens they examine may include blood, cerebrospinal fluid, feces, sputum, synovial fluid and urine. Microbiology labs often do testing to determine whether a particular pathogen is resistant or sensitive to a particular medication. A subdivision of microbiology is parasitology that investigates the presence or absence of parasites. Most frequently microbiologists investigate feces, though they may examine blood, sputum and urine specimens as well. Surgical Pathology Surgical pathology laboratory testing involves the examination of tissues biopsied from a variety of organs, limbs, tumors, fetuses, and other body parts, such as breasts. Toxicology Laboratories also test for toxins in the blood or urine, primarily for prescription or recreational drugs. Urinalysis Urinalysis tests for levels of various substances in the urine, including blood, glucose, bilirubin and protein. Urinalysis is very useful in diagnosing many diseases and conditions. Virology Virology testing is concerned with detecting and identifying viruses in specimens of blood, cerebrospinal fluid or urine. Common Laboratory Tests Laboratory tests are commonly performed as part of routine physical examinations. Perhaps the most common laboratory blood test is a complete blood count or CBC. Some of the other common laboratory tests which may show metabolic irregularities, organ or gland function, incipient or progressing disease processes, traumatic conditions or levels of prescribed medications may include tests for: Sugar in the blood Thyroid-stimulating hormone, or TSH Lipid levels for high cholesterol Other abnormal enzymes and proteins Levels of electrolytes such as sodium and potassium Waste products in the blood Levels of anticoagulants or other medications in the blood Common Pediatric Blood Tests Infants and children have some special laboratory needs. They are more prone to certain kinds of infections than adults and, since they have a tendency to eat inappropriate material, are more susceptible to certain types of poisoning. Some common pediatric laboratory tests for children and infants may include: Complete blood count, or CBC Tests of electrolyte level Blood cultures to test whether infections have become systemic Tests for lead poisoning Liver function tests to check for organ damage or possible mononucleosis or hepatitis Genetic testing to detect the presence and cause of a congenital defect

  Link: Medical Laboratory Testing

• Sports Physicals

  A sports physical exam, also known as a preparticipation physical examination (PPE), is a thorough medical examination that determines whether or not it is safe for an athlete to participate in a particular sport. The purpose of a PPE is to prevent as many injuries and medical emergencies on the court or playing field as possible Sports physicals are often required for children and teens before they are allowed to join a team sport and are usually repeated before each season. PPEs are required by most state governments as well. It is recommended that participants undergo sport physicals at least 6 weeks before the activity begins so there will be ample time if precautions or preparations are necessary. Medical History The first part of a sports physical involves the taking of a medical history. This is extremely important in terms of protecting the participant from possible danger during strenuous activity. The medical history includes information concerning: Illnesses of family members Chronic past disease conditions of the participant Present health conditions Prior hospitalizations or surgeries Allergies, especially severe ones Past musculoskeletal injuries or concussions History of chest pain, breathing difficulties History of dizziness or fainting Medications (prescribed, OTC or supplemental) This oral history is extremely important because awareness of possible underlying conditions, such as asthma or diabetes, may result in the physician prescribing particular treatments or recommending certain precautions, prior to exercise. It may also result in the physician prescribing medications for use if symptoms occur during exercise. In rare instances, the medical examination will make clear that participation in a particular sport is not recommended because of serious health risks. Physical Examination This examination is designed to detect any irregularities in the student's physical condition that may be warning signs of a medical disorder. By checking vital signs and evaluating general health, the doctor can be confident in approving sports participation. During a sports physical, the doctor checks and records: Height and weight Pulse and blood pressure Visual acuity and eye health Ear, nose and throat condition Heart, lungs and and bowel function Posture, muscular strength, flexibility During some physical examinations, an electrocardiogram (EKG) may be administered to further evaluate heart function or other diagnostic tests may be recommended.

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• Routine Physical Exam

  A routine physical exam is recommended at least once each year for patients of all ages. This complete medical examination allows the doctor to evaluate the patient's overall health and detect any illnesses or medical conditions in the early stages. Early detection of a disease may result in more effective treatment. An annual physical examination helps individuals to address any health issues and allows the doctor to give recommendations for healthy living and preventative care. The Physical Examination Prior to a physical examination, patients are encouraged to make a list of any questions or concerns that they may have regarding their health. Patients should discuss these concerns with the doctor during their appointment. The doctor performs a physical examination and takes routine measurements of weight, height and blood pressure. Various health screenings are also performed, depending on the age, health and family history of the patient. Additional tests may include: Blood tests Vision tests Hearing tests Osteoporosis screening Cardiovascular evaluation Breast exam Prostate screening Rectal exam Blood tests are commonly used to check cholesterol levels as well as to measure kidney, liver, thyroid, and heart function. The doctor will review the patient's immunization records and may administer any necessary vaccinations. An electrocardiogram or chest X-ray may be performed on patients with existing or suspected heart or lung problems. Physical Examination Results After a routine physical examination the doctor may recommend lifestyle modifications or prescribe medication, for any conditions that may have been diagnosed. Additional diagnostic tests may be recommended to further evaluate suspected conditions and create an appropriate treatment plan. By undergoing a routine physical examination and preventative screening tests, patients may increase their chances for living a longer, healthier life.

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• Bone Health

  Healthy bones are a necessity for a full and active lifestyle. Although we depend on our bones everyday for physical support and consider them strong and rigid structures, bones are actually living tissue, growing and changing on a regular basis. Along with the calcium that gives them their strength, bones are also made up of a collagen protein that gives them flexibility but also makes them susceptible to weakening and injury. Bone health is directly affected by lifestyle choices. Maintaining a healthy and active lifestyle helps to maintain healthy bones and prevent osteoporosis. While some factors that increase the risk of bone loss cannot be altered, such as gender, age, body build, and the ingestion of life-sustaining medications, others can be managed to help protect bone integrity. In order to maintain bone health, the following steps are recommended: Regular exercise Proper nutrition Adequate calcium and vitamin D consumption Avoidance of smoking and excessive alcohol use Avoidance, where possible certain medications Treat eating disorders promptly Anything that keeps the body from absorbing proper nutrition, like some types of bariatric surgery, anorexia or bulimia, or various gastrointestinal diseases, may result in weak bones because of lack of adequate calcium intake. Prolonged use of some corticosteroid medications, antidepressants, anticonvulsants medications and proton pump inhibitors may also be damaging to bone health. Low hormone levels in postmenopausal women, or in men with low testosterone can also result in diminished bone density. While some bone loss may be unavoidable during aging, taking appropriate steps to maintain bone health can keep such loss to a minimum.

  Link: Bone Health

• Complete Blood Count

  A complete blood count, or CBC, is a blood test used to measure the number of blood cells in the body and the ratio of one type of blood cell to another in the bloodstream. This information is invaluable in assessing the overall health of the patient and in diagnosing various infections, diseases or disorders. It provides specific information about the following: Red blood cells which carry oxygen throughout the body White bloods cell which fight infection Platelets which assist in the blood-clotting process Hemoglobin which carries oxygen to the blood and aids in the clotting process The ratio of red blood cells to plasma in the blood, called a hematocrit The complete blood count is essential in determining if the patient is in a good state of health since abnormal results may reveal blood disorders, such as anemia, leukemia, sickle cell disease, or the presence of infection. A complete blood count is often the first diagnostic test undertaken since it may be done during routine a physical examination. Complete blood counts are simple to obtain, necessitating only the withdrawal of a relatively small quantity of blood from the patient through a tiny hole in the vein. This process is called venipuncture. It is safe, quick, and almost painless. Complete blood counts are obtained in order for the doctor to confirm the healthy results of a positive physical examination or to diagnose one of the following: Infection Allergy Blood clotting disorder Blood abnormality such as anemia Other disease Sometimes a blood smear test is done at the same time as the CBC. In a blood smear, a drop of blood is spread thinly across a microscopic slide and stained with a special dye. When the doctor looks at this slide under the microscope the number, shapes and sizes of the various blood cells are visible, giving the physician an even clearer understanding of any disease process. During a blood smear, for example, abnormally shaped cells may indicate the presence of sickle cell anemia.

  Link: Complete Blood Count

• Employment Physicals

  Many employers require an employment physical to determine the suitability of an individual for a job. A pre-employment physical exam may be requested to ensure new hires are physically capable of performing their work and meet general health standards. Employment examinations may include physical examinations, health inquiries, psychological tests, drug testing, and mental health assessments. These exams compare the health of the potential employee with the expected demands of the job, to ensure that the individual is fit to do the job. The goal of the employment physical is to determine whether or not the prospective employee is capable of performing the physical demands of the job. The physical also intends to enhance safety at the workplace, and minimize the risk of work site-related accidents. If a prospective employee has some physical issues that are not essential to the job, the employment physical also allows the employer to make proper accommodations for the employee. Employment Physicals and Testing Employment physical examinations are often regulatory and compliance examinations for: Department of Transportation (DOT) Occupational Safety and Health Administration (OSHA) HazMat (Hazardous materials) These physical examinations are often required by the federal government and employees must pass a medical evaluation conducted by a healthcare professional prior to employment. Additional employment examinations and tests include: Pre-employment physicals Drug and alcohol screening Health risk assessments Executive physicals Fitness for duty examinations are also performed to medically evaluate the ability of a worker to return to duty after a medical leave. This examination can help to determine if the employee is fully able to perform the job or if any restrictions or accommodations may be necessary to protect the employee and employer. The Employment Physical Employment physicals may include exams tailored to the specific needs of a workplace. Prior to the examination, the patient's complete medical and occupational histories are reviewed and the physical examination commonly includes the following: Vision testing Hearing test Pulmonary function testing (PFT) Blood pressure check Height and weight check Physical abilities tests (PATs) Cardiovascular evaluation Drug testing Blood and urine tests are also administered. Some tests are tailored specifically to evaluate the physical requirements that are essential for the job. A physical examination benefits both the potential employee and the employer. Employers are assured that the employee is physically fit for the job, and employees can be assured of safe and appropriate assignments in the workplace.

  Link: Employment Physicals

• Flu Vaccination

  Influenza, also known as the flu, is a contagious virus that appears seasonally. It spreads from person to person and can cause mild to severe illness. Symptoms of the flu include fever, cough, sore throat, body aches, headache, chills, and fatigue. For some people, the flu can lead to serious complications, and possibly even death. According to the Centers for Disease Control and Prevention (CDC), up to 20 percent of Americans get the flu each year, and more than 200,000 people are hospitalized annually from flu-related complications. Flu season may start as early as October and usually subsides by May. Flu Vaccination Recommendations The influenza vaccine is recommended annually for adults and children age 6 months and older. In addition to protecting individuals, when healthy people get vaccinated, it helps to decrease the spread of flu and protect people who are at high risk of serious complications from the flu. Although most people recover from the flu without any complications, certain people have a higher risk for serious complications related to the flu. These may include: People age 65 and older Children age 2 and under People with compromised immune systems Pregnant women People with chronic medical conditions including diabetes, asthma, congestive heart failure, or lung disease are also at a greater risk for developing complications from the flu. Flu vaccinations are especially important for people in these high-risk categories. Types of Flu Vaccinations Traditional flu vaccines are created to protect against different flu viruses that scientific research has indicated will be most common during the upcoming season. The viruses in the flu vaccine change each year based on medical and scientific estimates about which types and strains of viruses will circulate in a given year. Influenza vaccinations are available as: The flu shot, an inactive vaccine that is administered through a needle The flu mist or nasal spray, a vaccine made with live, weakened flu viruses There may be certain restrictions associated with the different types of flu vaccinations, and patients should consult with their doctors prior to getting vaccinated. Risks of the Flu Vaccination A flu vaccination does not cause the flu and the risk of a flu shot causing serious complications is extremely low. However, as with any medication or vaccination, a severe allergic reaction, although extremely rare, is possible. Most people who get the influenza vaccine do not develop any problems. Possible side effects from a flu vaccine may include: Soreness or redness in the arm (from the flu shot) Low grade fever Mild body aches If experienced at all, these side-effects only last 1 to 2 days after the vaccination and are much less severe than an actual flu illness. Flu shots are generally available starting in September before the flu season begins. Protection provided by influenza vaccination can vary, based on health and age factors. While the flu shot may not always be completely effectively at preventing the flu, it may help to reduce the severity of the flu.

• High Blood Pressure

  High blood pressure, also known as hypertension, occurs when the pressure of the blood flowing against the artery walls is above the normal range. Blood pressure is determined by the amount of blood the heart pumps and the blood flow resistance in the arteries. If the heart pumps more blood than normal, and the arteries are narrower than normal, the result is high blood pressure. Untreated high blood pressure can cause serious health problems, including heart attack, kidney failure and stroke. There are two types of high blood pressure: primary and secondary. Primary hypertension is high blood pressure that develops gradually over the course of time, and secondary hypertension is high blood pressure that results from an underlying medical condition. Symptoms of High Blood Pressure Most people with high blood pressure do not have any symptoms. High blood pressure can gradually develop over the course of time without any symptoms. Prolonged and untreated high blood pressure may cause headaches, dizzy spells or nosebleeds. Causes of High Blood Pressure In most cases, the cause of high blood pressure, especially primary hypertension, is unknown. Secondary hypertension may be caused by various conditions or medications including: Kidney problems Thyroid problems Congenital defects in blood vessels Birth control pills Decongestants Certain prescription medications Obesity Alcohol or illegal drug abuse may also lead to high blood pressure. Risk Factors for High Blood Pressure Risk factors for developing high blood pressure may include: Family history Being African-American Increased age Obesity High sodium intake Excessive alcohol consumption Lack of physical activity or exercise Smoking Stress Chronic conditions such as kidney problems, hormone problems, diabetes, and high cholesterol may all increase an individual's risk of high blood pressure. Blood Pressure Diagnosis and Measurement Blood pressure is commonly measured during a physical exam. An inflatable arm cuff is fit around the arm and measures the blood pressure using a pressure-measuring gauge. This gauge yields two sets of numbers. The first number is the systolic reading, which is the pressure when the heart is beating. The second number is the diastolic number, the pressure when the heart is resting. High blood pressure occurs when the systolic reading is at 140 or higher and the diastolic reading is 90 or above. High Blood Pressure Treatment High blood pressure is often initially treated with lifestyle changes that may include: Losing weight Eating a healthy diet that is low in salt and fat Limiting alcohol intake Exercising and staying physically active Quitting smoking Hypertension that does not respond to lifestyle changes alone, is often treated with medication that may include alpha blockers, vasodilators, aldosterone antagonists, and central-acting agents. Treating any underlying conditions can also help to control high blood pressure. Complications of High Blood Pressure High blood pressure is a serious condition. Left untreated, hypertension may cause: Heart failure Kidney failure Heart attack Aneurysm Stroke Controlling blood pressure can reduce the risks of these complications.

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• Food Allergies

  A food allergy is present when the immune system has an abnormal reaction to proteins in a particular food. Food-allergy symptoms, which can be triggered by ingesting even minute amounts of the food, usually happen within minutes but may, occasionally, happen a few hours later. Food allergies can begin in childhood or in adulthood, with some people suddenly having allergic responses to foods that have never caused problems. In other cases, allergies appear after a food is consumed for the first time. Certain food allergies that affect young children may eventually go away. Some of the most common foods that cause allergic reactions are: Cow's milk Eggs Peanuts Tree nuts Fish Shellfish Wheat Soy Symptoms of Food Allergies Food allergies produce a wide range of symptoms. They may be relatively mild, causing only discomfort, or severe enough to be fatal. Any time an allergic reaction occurs, an appointment should be made with an allergist in order to determine the allergy's source. Symptoms of a food allergy may include: Itchy and/or flushed skin Hives Vomiting, abdominal pain and diarrhea Sneezing, runny nose and congestion Itchy or watery eyes Swelling under the skin (angioedema) In more severe cases, symptoms may include: Swelling of the throat, and hoarseness Difficulty breathing, and wheezing and chest tightness Dizziness or loss of consciousness Anaphylactic shock If an anaphylactic reaction occurs, emergency medical care should be sought immediately. Delaying treatment can result in coma or, even, death. Causes of Food Allergies A food allergy is caused by the immune system's incorrectly identifying a particular food as a potentially dangerous foreign substance. This initiates a reaction in which antibodies are produced to combat the allergen. Afterwards, whenever that particular food is eaten, the antibodies respond by triggering the release of histamines and other chemicals throughout the immune system. It is these chemicals that are responsible for the various symptoms food allergies produce. Risk Factors Associated with Food Allergies Certain people, with children being particularly susceptible, are more likely than others to develop food allergies. The risk for acquiring a food allergy may be higher in people with: Other allergy-related conditions (eczema or asthma, for example) A history of food allergies, even if symptoms have disappeared A family history of food allergies or other types of allergic reactions Diagnosis of Food Allergies Many people who experience reactions to foods have an intolerance to them rather than a true allergy. For example, lactose intolerance from milk is easily confused with a milk allergy. Food intolerance frequently has symptoms similar to those of a food allergy, especially if there is gastrointestinal distress involved. However, people with food intolerance can often safely eat a small quantity of the problematic food without having a reaction. In contrast, a person with a true food allergy typically cannot consume any amount of the trigger food without developing symptoms. Therefore, accurate diagnosis of true food allergies is important to prevent future allergic reactions. An allergist will be able to diagnose a food allergy by taking a patient's complete history, and performing skin testing and blood testing. Occasionally, an allergist-supervised "food challenge" may be required to confirm the diagnosis. Treatment of Food Allergies The most effective treatment for a food allergy is strict avoidance of the problematic food. Checking ingredient labels is a must, as is asking about ingredients in food prepared in restaurants and at the homes of others. For someone who has only mild allergic reactions, an antihistamine may be an effective treatment for relieving symptoms. For someone who experiences severe reactions, immediate medical attention is required, as is having an allergist prescribe injectable epinephrine that can be carried at all times.

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